Provider Demographics
NPI:1992331847
Name:KALINA, JOANNE (PA - C)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:KALINA
Suffix:
Gender:F
Credentials:PA - C
Other - Prefix:
Other - First Name:JOANE
Other - Middle Name:
Other - Last Name:STRYSZOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2650 RIDGE AVE STE 1223
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-1700
Mailing Address - Country:US
Mailing Address - Phone:479-826-7158
Mailing Address - Fax:847-982-3394
Practice Address - Street 1:2650 RIDGE AVE
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-1700
Practice Address - Country:US
Practice Address - Phone:847-570-2760
Practice Address - Fax:847-570-2921
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-22
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IL085007777363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program